Comparison of electrophysiological characteristics of right- and left-sided Mahaim-type accessory pathways

ÖZCAN E. E., TURAN O. E., Akdemir B., Inevi U. D., YILANCIOĞLU R. Y., Baskurt A. A., ...More

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, vol.32, no.2, pp.360-369, 2021 (SCI-Expanded, Scopus)

  • Publication Type: Article / Article
  • Volume: 32 Issue: 2
  • Publication Date: 2021
  • Doi Number: 10.1111/jce.14852
  • Journal Name: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.360-369
  • Bursa Uludag University Affiliated: Yes

Abstract

Aims: Mahaim-type accessory pathways (MAPs) are generally right-sided due to the embryological differentiation, but left-sided localization is also possible. This study aims to compare the clinical and electrophysiological characteristics of right- and left-sided MAPs. Methods: Of 251 patients diagnosed with AP by electrophysiological study between November 2015 and February 2020, 12 patients with MAP were included (right sided n = 8, left sided n = 4). MAP was diagnosed if; (1) no retrograde conduction; (2) anterograde decremental conduction; (3) adenosine sensitivity; and (4) Mahaim potential at successful ablation site were present. Results: Ten of twelve MAPs were clustered on the lateral walls of the mitral (n = 3, 75%) and tricuspid annuli (n = 7, 87.5%). Right-sided MAPs were mostly long pathways extending toward the conduction system whereas left-sided MAPs were short extending toward the neighboring myocardium. For right- and left-sided APs, the median QRS times were 129 and 156 ms (p = .042), the median V-Abl-RVApex intervals were -12 and 64 ms (p = .007), the median QRS-V-(His) intervals were 16 and 86 ms (p = .120), and the median V-Abl-QRS interval was -8 and 12 ms (p = .017), respectively. Coexistence of dual atrioventricular node physiology was observed only in right-sided APs (n = 3, 37.5%). Conclusion: MAPs are more typically located on the right but may rarely be seen on the left. Catheter ablation was associated with high success without complications.